John Kuckelman, is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Joint Base Lewis Mcchord, Washington. His current practice location is
9040 Jackson Ave, Joint Base Lewis Mcchord, Washington. You can reach out to his office (for appointments etc.) via phone at
(253) 968-1110.
John Kuckelman is licensed to practice in Washington (license number DO.OP.61502437-IMLC) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1669882304.
Physician's Profile
| Full Name | John Kuckelman |
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| Gender | Male |
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| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
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| Location | 9040 Jackson Ave, Joint Base Lewis Mcchord, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669882304
- Provider Enumeration Date: 05/03/2014
- Last Update Date: 05/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 0941516066
- Enrollment ID: I20220812000705
Medical Identifiers
Medical identifiers for John Kuckelman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669882304 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 92772 (Georgia) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | DO.OP.61502437-IMLC (Washington) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. John Kuckelman allows following entities to bill medicare on his behalf.
| Entity Name | Au Medical Associates Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1841230620
PECOS PAC ID: 9931013513
Enrollment ID: O20040107000188 |
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| Entity Name | Phoebe Physician Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487899464
PECOS PAC ID: 8426112350
Enrollment ID: O20090121000583 |
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| Entity Name | Wellstar Medical Group, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558664003
PECOS PAC ID: 6709065402
Enrollment ID: O20110127000374 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John Kuckelman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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John Kuckelman,
9040 Jackson Ave,
Tacoma, WA 98431-0001
Ph: (253) 968-1110 | John Kuckelman,
9040 Jackson Ave,
Joint Base Lewis Mcchord, WA 98431-1000
Ph: (253) 968-1110 |
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